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Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India

BACKGROUND: Drug resistance testing is limited in public-sector human immunodeficiency virus (HIV) care in India, and there are few systematic samplings for prevalent drug resistance mutations (DRMs), particularly among men who have sex with men (MSM) and people who inject drugs (PWID). METHODS: We...

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Autores principales: Clipman, Steven J, Solomon, Sunil S, Srikrishnan, Aylur K, McFall, Allison M, Gomathi, Selvamurthi, Saravanan, Shanmugam, Anand, Santhanam, Vasudevan, Canjeevaram K, Kumar, Muniratnam S, Celentano, David D, Mehta, Shruti H, Lucas, Gregory M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9547506/
https://www.ncbi.nlm.nih.gov/pubmed/36225747
http://dx.doi.org/10.1093/ofid/ofac481
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author Clipman, Steven J
Solomon, Sunil S
Srikrishnan, Aylur K
McFall, Allison M
Gomathi, Selvamurthi
Saravanan, Shanmugam
Anand, Santhanam
Vasudevan, Canjeevaram K
Kumar, Muniratnam S
Celentano, David D
Mehta, Shruti H
Lucas, Gregory M
author_facet Clipman, Steven J
Solomon, Sunil S
Srikrishnan, Aylur K
McFall, Allison M
Gomathi, Selvamurthi
Saravanan, Shanmugam
Anand, Santhanam
Vasudevan, Canjeevaram K
Kumar, Muniratnam S
Celentano, David D
Mehta, Shruti H
Lucas, Gregory M
author_sort Clipman, Steven J
collection PubMed
description BACKGROUND: Drug resistance testing is limited in public-sector human immunodeficiency virus (HIV) care in India, and there are few systematic samplings for prevalent drug resistance mutations (DRMs), particularly among men who have sex with men (MSM) and people who inject drugs (PWID). METHODS: We conducted genotypic resistance testing on 915 HIV sequences sampled from viremic self-reported antiretroviral therapy (ART) experienced and naive PWID and MSM recruited from 21 cities across India in 2016–2017. We analyzed factors associated with resistance using logistic regression and evaluated evidence for transmitted resistance using phylogenetic analyses. RESULTS: Of the 915 participants sequenced, median age was 31, 436 were MSM, and 191 were ART experienced. Overall, 62.8% of ART-experienced participants and 14.4% of ART-naive participants were found to have low-level resistance or higher to 1 or more classes of drugs. Prevalence of tenofovir disoproxil fumarate resistance was 25.7% in ART-experienced participants and 1.11% in ART-naive participants. The highest proportion of drug resistance was seen across nucleoside reverse transcriptase inhibitors and nonnucleoside reverse transcriptase inhibitors, and resistance was significantly more common among MSM participants than PWID. Phylogenetic analyses revealed that 54.6% of ART-naive participants with resistance who clustered had shared DRMs, suggesting transmitted resistance may have occurred. CONCLUSIONS: Patients experiencing virologic failure on first-line therapy switched blindly to tenofovir/lamivudine/dolutegravir may effectively be receiving dolutegravir monotherapy due to resistance to tenofovir and lamivudine. While dolutegravir is expected to have full activity in the majority of patients in India, follow-up is needed to understand how resistance may affect long-term outcomes.
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spelling pubmed-95475062022-10-11 Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India Clipman, Steven J Solomon, Sunil S Srikrishnan, Aylur K McFall, Allison M Gomathi, Selvamurthi Saravanan, Shanmugam Anand, Santhanam Vasudevan, Canjeevaram K Kumar, Muniratnam S Celentano, David D Mehta, Shruti H Lucas, Gregory M Open Forum Infect Dis Major Article BACKGROUND: Drug resistance testing is limited in public-sector human immunodeficiency virus (HIV) care in India, and there are few systematic samplings for prevalent drug resistance mutations (DRMs), particularly among men who have sex with men (MSM) and people who inject drugs (PWID). METHODS: We conducted genotypic resistance testing on 915 HIV sequences sampled from viremic self-reported antiretroviral therapy (ART) experienced and naive PWID and MSM recruited from 21 cities across India in 2016–2017. We analyzed factors associated with resistance using logistic regression and evaluated evidence for transmitted resistance using phylogenetic analyses. RESULTS: Of the 915 participants sequenced, median age was 31, 436 were MSM, and 191 were ART experienced. Overall, 62.8% of ART-experienced participants and 14.4% of ART-naive participants were found to have low-level resistance or higher to 1 or more classes of drugs. Prevalence of tenofovir disoproxil fumarate resistance was 25.7% in ART-experienced participants and 1.11% in ART-naive participants. The highest proportion of drug resistance was seen across nucleoside reverse transcriptase inhibitors and nonnucleoside reverse transcriptase inhibitors, and resistance was significantly more common among MSM participants than PWID. Phylogenetic analyses revealed that 54.6% of ART-naive participants with resistance who clustered had shared DRMs, suggesting transmitted resistance may have occurred. CONCLUSIONS: Patients experiencing virologic failure on first-line therapy switched blindly to tenofovir/lamivudine/dolutegravir may effectively be receiving dolutegravir monotherapy due to resistance to tenofovir and lamivudine. While dolutegravir is expected to have full activity in the majority of patients in India, follow-up is needed to understand how resistance may affect long-term outcomes. Oxford University Press 2022-09-17 /pmc/articles/PMC9547506/ /pubmed/36225747 http://dx.doi.org/10.1093/ofid/ofac481 Text en © The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Clipman, Steven J
Solomon, Sunil S
Srikrishnan, Aylur K
McFall, Allison M
Gomathi, Selvamurthi
Saravanan, Shanmugam
Anand, Santhanam
Vasudevan, Canjeevaram K
Kumar, Muniratnam S
Celentano, David D
Mehta, Shruti H
Lucas, Gregory M
Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title_full Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title_fullStr Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title_full_unstemmed Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title_short Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India
title_sort antiretroviral drug resistance in hiv sequences from people who inject drugs and men who have sex with men across 21 cities in india
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9547506/
https://www.ncbi.nlm.nih.gov/pubmed/36225747
http://dx.doi.org/10.1093/ofid/ofac481
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